Background The cause of epithelial ovarian cancer (EOC) is not elucidated. Viral infection may induce chronic inflammatory infection and play a role in the pathogenesis of cancers. Some viruses are considered to be oncomodulatory, modulating cellular pathways such as cell proliferation, tumor progression, vascular disease development, and immune evasion. Human cytomegalovirus (HCMV) has been detected in several types of cancers including ovarian cancer. However, the role of HCMV in ovarian carcinogenesis remains controversial. Objective To investigate the potential role of HCMV infection in EOC, we evaluated the prevalence of HCMV proteins in EOC tissue and its impacts on patients’ survival. Methods Formalin-fixed paraffin-embedded tissues from 66 patients with EOC and 30 patients with benign ovarian cystadenoma were studied. Specimens were analyzed for expression of HCMV immediate early protein (IE) and HCMV tegument protein (pp65) by immunohistochemistry. Results HCMV-IE protein expression was detected in 82% of EOC and 36% of benign tumors; pp65 was detected in 97% of EOC and 63% of benign tumors. Extensive HCMV-IE protein expression was associated with higher stage of EOC. Reactivation of latent HCMV within the tumor at interval debulking surgery may be induced by neoadjuvant chemotherapy before surgery. Extensive HCMV-IE expression was associated with shorter median overall survival than focal or negative expression (39 versus 41 months, P = 0.03). Multivariate analysis indicated that HCMV-IE expression was an independent prognostic factor for overall survival ( P = 0.034). Conclusions This study demonstrate a high prevalence of HCMV proteins in tissue sections from patients with EOC. HCMV infection can be potential risk factor for EOC development. Extensive HCMV-IE expression indicated a poor prognosis. The relationship between HCMV and clinical outcomes highlight the need for further researches on the oncomodulatory role of HCMV in ovarian cancer.

中文翻译：

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上皮性卵巢癌患者中人巨细胞病毒的检测及其对生存的影响

背景 上皮性卵巢癌 (EOC) 的病因尚未阐明。病毒感染可诱发慢性炎症感染并在癌症的发病机制中发挥作用。一些病毒被认为具有肿瘤调节作用，可调节细胞途径，例如细胞增殖、肿瘤进展、血管疾病发展和免疫逃避。已在包括卵巢癌在内的多种癌症中检测到人类巨细胞病毒 (HCMV)。然而，HCMV 在卵巢癌发生中的作用仍存在争议。目的探讨 HCMV 感染在 EOC 中的潜在作用，我们评估了 HCMV 蛋白在 EOC 组织中的流行情况及其对患者生存的影响。方法对66例EOC患者和30例良性卵巢囊腺瘤患者的福尔马林固定石蜡包埋组织进行研究。通过免疫组织化学分析样本的 HCMV 即刻早期蛋白 (IE) 和 HCMV 外皮蛋白 (pp65) 的表达。结果82%的EOC和36%的良性肿瘤中检测到HCMV-IE蛋白表达；在 97% 的 EOC 和 63% 的良性肿瘤中检测到 pp65。广泛的 HCMV-IE 蛋白表达与 EOC 的较高阶段相关。手术前的新辅助化疗可能会在间隔减瘤手术中重新激活肿瘤内潜伏的 HCMV。与局灶性或阴性表达相比，广泛的 HCMV-IE 表达与较短的中位总生存期相关（39 个月对 41 个月，P = 0.03）。多因素分析表明HCMV-IE表达是总生存期的独立预后因素（P = 0.034）。结论 本研究表明 EOC 患者的组织切片中 HCMV 蛋白的流行率很高。HCMV 感染可能是 EOC 发展的潜在危险因素。广泛的 HCMV-IE 表达表明预后不良。HCMV 与临床结果之间的关系突出表明需要进一步研究 HCMV 在卵巢癌中的肿瘤调节作用。